Chiropractic During Pregnancy

Hands-On Pregnancy

FROM THE WEBMD ARCHIVES

Feb. 18, 2002 -- Shawn Kelley delivered her first son, Evan, prematurely at 32 weeks. It looked like she was headed down the same path with her second baby when she started having contractions at 22 weeks. That is, until she tried an unconventional treatment that seems to be working.

Kelley started seeing a chiropractor, and within a few sessions of gentle manipulations the baby had moved up. She was no longer experiencing severe back pain and her obstetrician gave her the green light to cease bed rest and resume normal activity.

"It's amazing," says Kelley, of Minnetonka, Minn., who is now 33 weeks pregnant with her second baby . "I'll go in, she does some adjustments, and within an hour or two, everything opens up. The baby moves up, I don't feel as much pressure, and the back pain goes away." What's more, she says, she has been able to avoid more bed rest or drugs to stop pre-term labor.

Kelley has joined the growing ranks of Americans -- pregnant women included -- seeking alternatives to traditional Western medicine. Chiropractic care appears to offer many women relief from the back, leg, and pelvic aches and pains common during pregnancy.

"The best use of chiropractic, in general, has to do with musculoskeletal problems, and, in pregnancy, a lot of women have problems that are caused by the uterus being off center," says Mary Hammond-Tooke, a certified nurse-midwife at The Maternity Center in Bethesda, Md. "The uterus is pulling out in front and not well-balanced in back."

Add to that the hormonal changes that soften joints -- and even the strain of balancing another child on one hip -- and an expectant mom can be in for some major body stressors. "Chiropractors who are comfortable with pregnant ladies -- and not all of them are -- do just a wonderful job helping these ladies to be much more comfortable or pain free," says Hammond-Tooke.

More Popular Than Ever

Chiropractic is one of the most popularalternative medicinetherapies, ranking fourth after relaxation techniques, herbs, andmassage, according to a recent survey by David Eisenberg, MD, of Harvard University and Beth Israel Deaconess Medical Center in Boston. About 22 million Americans visited a chiropractor last year, according to Jerome McAndrews, national spokesman for the American Chiropractic Association, although there are no statistics on how many of those are pregnant women.

As I tried to lift my 2-year-old son, a sharp pain shot down my back, and I cringed in agony.

The back pain that I’d dealt with for years was creeping back, just as my belly started to grow during my fourth month of pregnancy.

For about a month, I tried to suck it up and deal with it. I treated myself to a pregnancy massage, instructing the therapist to ignore the rest of my aching body and rub out the big knot that had formed on the right side of my lower back.

I tried to relax and stay on the couch and rely more on my husband’s help for the care of our son.

But my job as an on-the-go reporter doesn’t allow for much downtime, so I knew what I had to do: Go see my chiropractor.

Everyone has different views about seeking chiropractic help. Some people say it helps everything from asthma to infertility. Others grimace at the slight mention of a chiropractor.

A few years ago, I’d suffered back pain that eventually got so bad I couldn’t bend down to load the dishwasher. I sought relief from Dr. Larry Omo, a chiropractor who has a practice in Lakewood and lives in Garden Grove. A few visits to his office, and I was good as new.

But being pregnant and getting twisted up like a pretzel made me nervous. I’ve gone to enough prenatal yoga classes to know that big twists are not recommended after the second and third trimester.

I started doing some research. According to the American Pregnancy Association, most chiropractors are trained to work with women who are pregnant, and some have additional training for prenatal and postnatal care.

A growing belly can increase the back’s curve, and the pelvic area changes as the hips expand. Hunching over with more weight on the front side of the body can cause the pelvic bones to misalign and reduce the amount of room for the baby.

Discussing my pain with Omo and reading extensively on the topic calmed my nerves, and I decided to go forward with chiropractic care. Omo’s table had a pop-out section for my belly, so I could lie face down as he worked on the knot that had developed in my back. He also incorporated massage work on tight areas and worked on stretching the muscles out. After three visits, my back pain was cleared up.

Omo says it’s common for pregnant women to come to his office seeking relief. A substance called relaxin kicks in during pregnancy, helping to soften the ligaments so your body can expand for the birth of the baby, he explains. “When a pregnant woman advances into her pregnancy, and the relaxin comes on and you have more weight carrying in the front, the mom has to adjust posture to carry the weight,” he says.

That can cause instability in the ligaments, and the muscles try to overcompensate, he says. The muscles start working double duty – moving and stabilizing because of the extra weight and lack of stability.

There are also sciatic nerve issues that can cause shooting pain down the legs that can be eased with help from a chiropractor, Omo says.

“When you have good alignment and muscle balance going into birth, you will optimize the ability for the baby to come out. It will be less stressful for the mom,” Omo said. “Birthing is a symmetrical process. We try to keep the back relaxed and symmetrical.”

Did you know that during our lifetime, 70% of us will have back pain? Seventy percent! Some of the many reasons that may cause us back pain are weight gain or pregnancy, a slip or fall, improperly lifting heavy weight, sleeping on a poor mattress or automobile and sports related accidents. If you have or have ever had back pain, you know how painful it can be. And a herniated disc is even worse.

When a spinal disc herniates, the jelly-like fluid in the center of the disc leaks out, irritating no-longer protected nerves. Talk about pain! It rarely goes away. Typical treatments include pain killers, narcotics, muscle relaxers, cortisone injections and surgery. But recently, a research paper documented the highly effective results attained by chiropractic care.

In this study, 148 patients between the ages of 18 to 65 years with lower back pain and leg pain who were also confirmed to have lumbar disc herniation from an MRI study, were given chiropractic care. The process, described by the researchers as, "high-velocity, low-amplitude spinal manipulation," was delivered by doctors of chiropractic in Zürich, Switzerland.

The results of the study showed that after only 2 weeks of care, 69.9% considered themselves better or much better. After one month of chiropractic care, 79.6% were better or much better, as were 90.5% of the patients at the three-month evaluation.You can read the full study here.

If you or a loved one suffers from back pain or a herniated disc, please pass along my contact information. Our office offers spinal decompression, core strength building exercises and chiropractic adjustments specific to herniated discs. My goal: A Better Back - A Better Life.

From the Journal of Clinical Chiropractic Pediatrics comes a case study published in the March 2014 edition that reviews the case of an infant with gastro-esophageal reflux disease improving while under chiropractic care. The author, Dr. Andrew Chuang, a chiropractor in Melbourne, Victoria, Australia, notes that prior to this study available literature discussing the use of chiropractic for cases of gastro-esophageal reflux (GER) and gastro-esophageal reflux disease (GERD) was sparse with a limited number of case reports showing up in scientific literature.

Dr. Chuang begins by highlighting the frequency of these problems by reporting, "Gastro-esophageal reflux disease (GERD) is common during the first year of life, peaking at 4 months of age." In noting a prior study he writes, "Regurgitation of at least 1 episode per day was reported in half of 0- to 3-month olds."

In this case, a 4-month-old female infant was brought in for chiropractic care by her mother. According to the infant girl's mother, her baby had been vomiting after feedings for the past 2 months. A prior visit to her MD yielded a diagnosis of gastro-esophageal reflux disease (GERD). The medical doctor then recommended the infant be placed on Ranitidine for the condition. Her mother was hesitant to start her baby on medication at such a young age, and chiropractic care was sought as an alternative.

A physical examination revealed no physical abnormalities in development, except the child had not gained any weight in the past two months. A chiropractic examination which included a postural examination as well as static and dynamic palpation of the spine was performed. From this chiropractic examination, it was determined that the child had multiple subluxations in her neck.

Specific chiropractic care was begun to correct the spinal issues. The mother reported that after the first adjustment, her infant girl had a large bowel movement, and slept for a longer period of time than normal. The study further noted that over the next 3 weeks both the number of episodes of vomiting and reflux per day decreased, and the number of days with vomiting decreased. After 4 weeks of chiropractic care, the mother reported that her baby was no longer having any episodes of reflux and vomiting.

In his conclusion, Dr. Chuang wrote, "In the case described here a 4-month-old patient’s GERD resolved while under chiropractic care. This study suggests to the possibility that similar patient groups may benefit from chiropractic treatment."

A case study research paper was published in the March 2014 issue of the Journal of Clinical Chiropractic Pediatrics documenting the improvement with chiropractic care of a seven-week-old infant with difficulty breastfeeding.

In this case, a seven-week-old infant girl was brought to the chiropractor with what her mother described as tummy pain. It was noted that the infant was in distress, did not want to sleep on her back, was drawing her knees up to her chest, vomited after feedings, and had unusual stools. She was also having recent trouble breastfeeding after having no problems doing so since birth. She would only feed on her mother's left breast and had great difficulty trying to feed on her mother's right side.

The chiropractic examination indicated the child was in significant distress and pain. The infant showed a significant restriction in movement in the neck which could partially explain her inability to breastfeed on one side. It was determined that subluxations were present at the base of the skull and upper neck area. Subluxations in this area can affect the nervous system in many ways including the ability of the child to move her head properly and therefore breastfeed.

Care was initiated for correction of the subluxations and restoration of proper movement of the infant's neck. After one week, it was noted that the child could move her head better and was able to breastfeed more normally. Her initial stool after her first adjustment was normal. Over the next few weeks, her other symptoms decreased and eventually cleared.

The authors reported, "A follow-up chiropractic progress examination was performed when the infant was 6 ½ months. During this examination the infant was found to be happy, symptom free and developing well."

In their conclusion the authors wrote, "Craniocervical subluxations are often identified in infants as a result of the birth process. In this case, chiropractic care restored optimal cervical range of motion and cranial alignment. Consequently, the infant no longer showed a preference to feed on the left breast. This demonstrates how chiropractic treatment may be beneficial in correcting breastfeeding difficulties that have a biomechanical cause."

A research paper published in the March/April 2014 issue of the scientific periodical, the Journal of Manipulative and Physiological Therapeutics (JMPT), showed that patients with lumbar disc herniations found on MRI were helped by chiropractic. The authors explain, "The purposes of this study were to evaluate patients with low-back pain (LBP) and leg pain due to magnetic resonance imaging–confirmed disc herniation."

In the opening of the report the authors write, "Approximately 70% of the population will have back pain at some point in time.1 Low-back pain (LBP) with associated leg pain due to a herniated intervertebral disc is one of the most severe and disabling forms of back pain."

The study looked at patients with either chronic long term back pain or acute lower back pain, and followed their results for up to a year after the onset of chiropractic care. The researchers compared the patients, "...short-, medium-, and long-term outcomes of self-reported global impression of change and pain levels at various time points up to 1 year."

In this study, 148 patients between the ages of 18 to 65 years with lower back pain and leg pain who were also confirmed to have lumbar disc herniation from an MRI study, were given chiropractic care. The process, described by the researchers as, "high-velocity, low-amplitude spinal manipulation," was delivered by doctors of chiropractic in Zürich, Switzerland.

Patients accepted for the study were evaluated at the time frames of 2 weeks, 1 month, 3 months, 6 months and 1 year after the initial chiropractic consultation. The patients were asked to self-evaluate themselves into one of the following categories which included, "much worse, worse, slightly worse, no change, slightly better, better, and much better."

The results of the study showed that after only 2 weeks of care, 69.9% considered themselves better or much better. After one month of chiropractic care, 79.6% were better or much better, as were 90.5% of the patients at the three-month evaluation. After that point, with no additional chiropractic care being rendered, the results remained at 88% better or much better with only 2.8% reporting that they were worse to some degree.

The authors said that in all the patients included in this study, "There were no adverse events reported." In their conclusion, the authors noted that the results were very good for both those patients who had acute or chronic lower back issues due to disc herniation. "A large percentage of acute and importantly chronic lumbar disc herniation patients treated with chiropractic spinal manipulation reported clinically relevant improvement."

The Annals of Vertebral Subluxation Research published a study on March 3, 2014, showing that chiropractic has a positive effect on resting heart pulse rate (PR). This study was designed to look at the PR of subjects immediately after a chiropractic adjustment in the upper neck.

The author of this study, John Hart, DC, MHSc Assistant Director of Research at Sherman College of Chiropractic, Spartanburg, SC, noted that prior studies have shown various results, with most showing a lowering of the PR after chiropractic adjustments. The significance of this study helps add to the body of evidence that chiropractic care can affect all functions of the body.

Dr. Hart explains, "One approach in chiropractic practice is to focus on a condition known as vertebral subluxation (now referred to as "subluxation"), generally defined in concept as a minor misalignment resulting in some type of neurological disturbance. An objective in adjusting subluxation is to improve neurological function (e.g., reduction / removal of nerve interference between the brain and the rest of the body)." If subluxations interfere with nerve system function, this should cause changes in bodily functions such as PR that can be measured before and after a chiropractic adjustment.

In this study, 23 chiropractic students were examined on three visits; two pre-adjustment visits and one post-adjustment visit. The process used for inclusion in the study was to sample the PR on the first and second visit. Then only if the PR increased between these two visits (with no chiropractic adjustment being given) would the subject be included in the study. Once included, the subject was then given a specific chiropractic adjustment designed to correct subluxation, and a third, post adjustment PR reading was done for comparison.

The results were varied, with a marked difference between how the males and females in the study responded. In the study, all but one of the males showed a decrease in their PR after their adjustment. However, only about half of the females showed a decrease, with the remainder showing a continued increase in the PR.

Although more pronounced in men than in women in this study, the results did show that correction of subluxations does have an effect on the resting pulse rate, and therefore, on body physiology controlled by the nervous system.

From the Journal of Upper Cervical Chiropractic Research comes a study published on Jan. 16, 2014, which documents the case of a woman who regained her senses of both smell and taste due to chiropractic care. Anosmia, the loss of the ability to smell, and ageusia, the loss of the ability to taste, affects between 1 and 2 percent of the American population under the age of 65 years.

The authors of the study report that approximately 200,000 people visit physicians each year for smell and taste related disorders. According to studies, one of the most common causes of smell and taste disorders is a previous injury to the head and/or neck. Because these conditions are not life threatening, the authors note that there is little medical attention or treatment for these problems.

In this case, a 64-year-old woman went to a chiropractic clinic with complaints of neck pain, right sided knee pain, and a loss of the ability to taste and smell. She reported having lost the ability to smell and taste nine months prior to her visit to the chiropractor.

A chiropractic examination revealed sensitivity in the upper neck upon palpation, as well as thermal scan irregularities. There was also a reduction of the woman's range of motion in her upper neck. Postural abnormalities were also noted and spinal x-rays confirmed misalignments of her neck vertebrae.

Specific chiropractic adjustments were begun to correct the subluxations that were determined to be present. According to the case report, within 48 hours of the woman's first adjustment, her sense of taste and smell had started to return, and her pain symptoms improved. By the third month of care, she had completely regained both her sense of smell and taste.

In their conclusion the authors wrote, "This case described the successful resolution of anosmia and ageusia following the introduction of upper cervical chiropractic care. This case study suggests that there may be a role for the use of precise upper cervical chiropractic care in the management of patients with smell and taste disorders in patients with a history of head and neck trauma."

Resolution of Chronic Constipation and Abdominal Pain Following Chiropractic

The Annals of Vertebral Subluxation Research published a case study on Jan. 20, 2014, documenting improvement in constipation and abdominal pain in a young boy who received chiropractic care. The study authors note that the prevalence of constipation ranges from 0.7% to 29.6% in children worldwide. A Medical Expenditure Panel Survey found that between 2003 and 2004 an estimated 1.7 million children in the United States suffered from constipation.

In this case, an 8-year-old boy was brought to the chiropractor with a history of constipation and associated problems that had been present since birth. On average, the boy would only have one bowel movement per week, and he also suffered from some involuntary releases. Additionally, he was experiencing long-term severe abdominal pain. The boy's problems and pain resulted in him not enjoying recess at school, and resulted in weekly calls from school reporting "accidents" related to his problem.

A pediatrician and a gastroenterologist prescribed medications which had little or no effect. Medical x-rays did not reveal any problems, and finally, the doctors recommended exploratory surgery. The boy's mother did not want to pursue the exploratory surgery, deciding to go with chiropractic instead.

A chiropractic examination was performed that included palpation, spinal range of motion, thermographic studies, and spinal x-rays. It was determined that subluxations were present and chiropractic care was started. Dietary changes to increase water intake and decrease sugars were also recommended.

A re-evaluation performed after 12 chiropractic adjustments showed a marked improvement in the thermal scans. The boy's mother reported that her son was having regular daily bowel movements and was no longer having any accidents. Because of his improvement, the boy was now enjoying outdoor activities for the first time in his life. He began playing sports such as soccer and enjoying a normal life.

In their conclusion the authors wrote, "This case reports on the successful resolution of symptoms of a child with chronic constipation and fecal incontinence through chiropractic care. Subluxations were detected and corrected to restore proper biomechanical and neurological function. This case contributes to an already existing body of case studies within the chiropractic literature."

The Journal of Pediatric, Maternal and Family Health, published a study on Dec. 23, 2013, documenting the case of chiropractic helping with childhood nocturnal enuresis, more commonly referred to as bedwetting.

According to the study authors, "Nocturnal enuresis is defined as repeated voiding in clothing or bed that occurs in a child over the age of 5, and occurs at least 2 times per week for more than 3 months. Bedwetting is one of the most frequent problems seen in childhood, and affects roughly 10 percent of all children at the age of 7."

In this case, a 10-year-old boy was brought to the chiropractor with the complaint of neck pain. The issue of bedwetting was not mentioned when the child was brought in for chiropractic care, even though the problem was chronic in nature, and he was wetting his bed 2 to 3 times per week. The boy was also having diurnal enuresis, also known as daytime wetting, which the mother described as "leakage."

A chiropractic examination was performed including posture observation, palpation, functional leg length analysis, and spinal range of motion. Based on the examination, it was determined that the child had multiple vertebral subluxations that caused nerve system interference.

Chiropractic adjustments were begun for the correction of the boy's subluxations. On the second visit, the boy's mother mentioned the bedwetting and reported that her son only had one incident of bedwetting after the first adjustment. For various reasons, there was a break in the boy's care, during which time he had several episodes of bedwetting. Upon his return to chiropractic care, these episodes decreased and eventually discontinued. Over the next eight weeks of care, only one incident of bedwetting was reported, and no daytime wetting had occurred.

The study also recorded that after the boy's first adjustment, his neck was not hurting. At his third appointment, he stated that his neck was again hurting from sleeping wrong. After the adjustment on his third visit, he never mentioned any more trouble with neck pain.

In their conclusion, the authors sum up this case by stating, "The case report of a ten-year-old boy who is dealing with a history of nocturnal enuresis is presented. Chiropractic evaluation and care is presented with subluxations noted and adjusted. A decrease in severity and frequency of enuresis was noted. While more studies need to be performed, chiropractic care appears to be beneficial in the effects on nocturnal enuresis in children and adolescents."